Consequences of failure to diagnose may result in multiple visits to the ED and other provider settings. One study documented that 23 percent of battered women presented to clinicians between 6 and 10 times, and another 20 percent at least 11 times before the abuse was diagnosed. 22 In addition, misdiagnosis of battering-related symptoms such as mental illness can lead to misleading at best and inappropriate use of psychoactive medications or psychiatric hospitalization at worst. It has been estimated that many women hospitalized in psychiatric institutions are, in fact, battered women. 23
Other consequences of failure to diagnose include an increase in the patient's feelings of hopelessness, despair, isolation, and entrapment. Battered women may resort to substance abuse or develop depression with and without suicide attempts. Continuing or escalating domestic violence can lead to permanent disability or death. Domestic violence has adverse consequences for the children of victims as well. Perpetrators of domestic violence abuse the children in the home in approximately 30 percent of cases.24 Even if the children are not physically or sexually assaulted, experiencing or witnessing violence in the home as children has both short-term and long-term health consequences, including an increased incidence of adverse health-risk behaviors as adults. 1925 Finally, failure to interrupt the cycle of violence can lead to repetition of violence in the next generation. 26
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